Let's Talk About Sex! (with Dr. Stephanie Emde)

What if the person who “has it all together” is carrying a secret that’s slowly dismantling their life? We sat down with Dr. Stephanie to unpack sex addiction without euphemisms or moralizing—how it hides, why it’s misdiagnosed, and what real recovery looks like when shame no longer runs the show.

We trace the path from early trauma to skewed arousal templates, showing why a “high sex drive” is not the same as compulsion. Dr. Stephanie walks through clear, addiction‑style criteria you can actually use, plus the questions most therapists avoid but must ask—frequency, rituals, search terms, and technology habits that turn secrecy into a second life. We explore non‑monogamy through the lens of consent and rule‑keeping, why pop psychology flattens people into labels, and how partners experience profound betrayal trauma long before they get language for it.

On the treatment side, we dig into modalities that move clients from performance to presence: somatic experiencing, psychodrama, inner‑child and parts‑based work, alongside structured group processes that bring shame into the light. We talk openly about chemsex and meth’s dangerous fusion with sexual behavior, the grief of letting go of the “big high,” and the daily practices that make recovery durable—aftercare, check‑ins, and living in consultation. Sexual sobriety here means integrity and safety, not celibacy, and rebuilding intimacy starts with trust the partner can feel in their body, not promises on paper.

If you’re a clinician, partner, or someone who wonders whether what you’re facing is addiction or avoidance, this conversation offers criteria, tools, and hope. Subscribe, share this episode with a colleague or friend, and leave a review to help more people find the support they need.

If you or someone you love is struggling with addiction, you don’t have to face it alone.

Valiant Living helps men and their families move from crisis to stability through clinically driven care, community, and hope.

Learn more about our programs at www.valiantliving.com
or call us confidentially at (720) 796-6885 to speak with someone who can help.

Transcript

Setting The Scene At The Symposium

SPEAKER_06 0:07

Well, hey friends, welcome back to another episode of the Guy Living Podcast. We're doing something a little bit different today. Uh, just a few weeks ago, we had a chance to uh visit and attend the annual winter symposium. It's uh it's an event for the springs that we love with a lot of our friends and our partners. Just at the stage of that Tuesday morning at around 7 o'clock a.m. And we get an email from the composite asking if we could still end uh for sex back out last second. So uh we decided to jump in and have a conversation uh sex addiction, process addiction, and uh Dr. Stephanie M is our chief growth officer here at IM Living, and uh may I have shared some amazing stuff on this episode. Now, just to give you some context, there's a room full of people that are asking questions, and I want to have just left the questions in there. Um I have a little bit of co-op sharing, um, but I thought the answer was still so good that I just left it as so we hear over that spot the episode. That's what's happening if you're asking questions, and then Dr. Emy will go back up with the answer. Um, so I really hope you enjoyed this a lot of good stuff in this episode. So let's dive in uh to this episode with Dr. Stephanie Emdy. So we're gonna talk a little bit about sex. I'm uh Drew. I'm part of the Valiant Living team. I also went through the program back in 2022. Uh sex addict, went there for 90 days. And um, Dr. MD is our chief growth officer. And I want to get to know you a little bit before we jump right into the topic. By the way, we're gonna talk for I don't know how long, it may not be all that long. We got some questions, but we want to hear your questions, and we really want this to be a conversation as well. And so just be thinking about stuff you might want to ask. We know we got a lot of great people in the room, a lot of experts outside of just you know who's up here. So let's have a conversation about this. Um get to know you a little bit. Tell us a little bit about your story. How did you get into this this wonderful space?

SPEAKER_01 2:12

Oh man, I think kind of like all of us, right? Uh you're there's a piece driven, right? I think ever since I was a kid, I always wanted to know about other people and help other people and get to know them and and understand why people did the behaviors that they did, right? And then there's a little bit of or a lot of addiction in my family. Uh, and so then that led me towards addiction. Um, so when I was looking at my degree, I really knew psychology was it. And I was trying to figure out well, what kind of psychology do I want to sit in a room with uh marriage, family, and therapy, right? Do I want to listen to people who are trying to build their relationships back up? And back at that point, I was like, no, no, thank you. Uh so let's do clinical forensic psychology. I'm gonna get some legal in there, some criminal in there, some psychology in there. It it focused on my background of having family of addiction. What does that look like? So I started in uh downtown San Diego for crisis centers. Uh, you know, two weeks to 30 days of treatment straight out of a 5150. Um, and then I made my way to a men's maximum security prison. Um, and and those were some interesting four years. Uh, you learn a lot about the addiction, you learn a lot about the family system, you learn a lot about human behavior and watching it change. And there's nothing greater for me than walking into a session with a client who's never trusted anyone in their entire lives. And they will stand between you and 400 inmates on the other side of that wall because they know that you're there to help them. There's nothing better than that. So, like for me, I found a lot of passion in working with people who had trust issues because to show them something different was a magical experience.

Resilience, Trust, And Guarded Hearts

SPEAKER_06 4:07

Can we lean into that a little bit more? How did that shape, that experience shape just how just human behavior and kind of how you kind of see these people that you're you're dealing with and treating?

SPEAKER_01 4:16

Well, you know, I see trauma turns into resiliency. But resiliency can sometimes be that counterproductive piece that keeps you from having the connections that you've always wanted. Right. So I've learned that people will harm me. So now I'm extra guarded for anyone who comes in. But that means I not only just push out the bad people, right? But I push out the ones who are there to help me. I push out the ones who do love me, who have, who do want to show up for me. And then I start doing these behaviors to make sure that they don't, because I'm a little prickly and I want to poke people a little bit, right? Because I don't want to get poked first. So for me, that was resiliency in an area that they grew up in, an area that they that they lived in their their lived experience. But it was also harmful for them to ever do anything different with their lives.

SPEAKER_06 5:04

Was there a part in your journey or when was it when you're when you decided, hey, I want to work specifically with sex addiction, intimacy disorders? Can you unpack how you specifically got into that?

SPEAKER_01 5:14

I didn't. That wasn't your little girl dream. That was not my dream, no. Um, to be honest, so I kind of fell into doing write-ups at the prison. So when you're doing the mental health part of the prison, when they get in trouble, you then have to do a write-up on it. So is it a mental health condition that had them do this behavior? Is it not? And a lot of that was sex stuff. It could be masturbation, it could be uh exposing themselves to a staff member, it could be sexual activity with another inmate. Um, and my boss started off with just telling me this is a really easy job. Don't worry about it, Stephanie. You go in and you're like behavioral and you sign off on it. And I'm like, uh, all right, but I have to interview them, right? It's like, yeah, like, okay. So I go and interview them. And what I come to find out is these are generational things that have been passed down, right? Like these are men who've been taught that masturbation can calm you. And it's not, I mean, it's scientifically correct, right? It is, it's a calming. You're gonna have some dopamine. There's gonna be these chemical things that happen that are going to relieve that stress in the moment. And prison is stressful. So it's like when that stress increases, now we're doing these behaviors that calm us to make us feel better. No, that's mental health. So now I'm like, great, I gotta go to my boss, who's my supervisor, gotta sign off on my hours, and they gotta tell him he's wrong. Oh, this is gonna be fun. So now I'm researching, right? Now we just hit that research, and like, let me find as many articles as I can, let me prove this right. I go and I lay out all these articles, and I'm like, okay, hear me out. I know you said this would be easy. And he was like, Let me guess. It hasn't been easy. And I was like, Well, like, hear me out. I found all these articles and there's peer-reviewed evidence, and and he just kind of smiled at me and he was like, Welcome to being an independent therapist. You took your own view, you assessed it, you did the research, and you came up with your own answer. That's what I wanted to see. And I was like, jerk.

SPEAKER_06 7:19

I'm pretty sure that's not what you said. I know you better than that. But yeah, I'm trying to be PR right now.

SPEAKER_01 7:24

Uh so yeah, it was and especially in a prison, it was not in my head.

SPEAKER_06 7:28

You didn't say jerk.

SPEAKER_01 7:29

If anybody knows Mark Lundholm, it was like first thought wrong. Uh, so yeah, it was uh it was a test, but it was something that made me recognize there are biases out there, right? As therapists, we get to hear all the time what should we be looking at? How should we be dealing with something? What is the cause of this behavior? Is this behavior actually something that's mental health or is this just a moral failing? And so that taught me that I need to look into it myself and make my own decision for it, which gets me into sex addiction, right?

SPEAKER_05 8:02

Yeah.

From Forensics To Sex Addiction Work

SPEAKER_01 8:02

So I'm looking to move out of California at one point. My son's getting ready to be a senior in high school. He's he wants to go in the military. Um, there was a lot of stuff happening in California at the time that just was putting him at risk and where we lived. And he didn't want to get into the bad crowd. And he wanted to move to Arizona. He thought Arizona would be a great place to move for him to get ready for the military. So I'm like, all right, well, I got to find a job there, single mom. Let's let's see if we can do that. So I got an offer from the Meadows for a gentle path for their clinical director role. And when they called me, they were like, hey, so we do have a clinical director position open. It is for our men's only sex addiction facility. And I'm like, sex addiction. Do I believe in that? Okay. Well, let me do some digging. Let me see what that looks like. Let me go see you guys. Let me see where your facility is. Let's talk. Who's your founding fellow? What does that look like? And so I did. I just dug into Patrick Carnes's videos. I started doing some research on what his evidence-based research was and what his treatment facility did and how they treated their patients and what they believed in. Um and that's what led me to sex addiction. But it definitely wasn't, I don't think, my calling at the time, nor something I was looking for.

SPEAKER_06 9:21

What are some of the biggest misconceptions that you've run into in this area of sex addiction, just in your experience?

SPEAKER_01 9:29

Pop psychology. Uh, the videos out there, right, about narcissistic men and that um how to treat it and and what you should watch for and and that trauma's behind it, you know, like those pop psychology videos, those little 10-second TikToks, don't tell you what's behind the narcissism. They don't tell you what's behind the personality trait. They don't tell you the trauma that person's experienced in order to develop that type of resiliency to behave the way that they do. So when you walk into a situation like that and you're trying to talk to spouses, you're trying to talk to family members, you're trying to get people to understand why this is something that needs to be treated, those things pop up. But I saw a video the other day about narcissistic men and how they can never be fixed or whatever. And I'm like, so have we ever talked about the trauma that's underlining for your husband? Have we ever talked about the trauma that's underlining for your son? Have we ever talked about the trauma? Because if we're not talking about the trauma, we're missing a big piece.

SPEAKER_06 10:27

That's good. How is your like place at a gentle path and now at Valiant Living refined or even changed the way you assess and treat this population?

Misconceptions: Pop Psychology And Narcissism

SPEAKER_01 10:36

That's a great question. So uh when you work for the founding father of who's developed the treatment, right? There's a lot of nuances. Um and it's very rigid. So it's like the treatment must happen in this specific way. Um that's really hard for me. Humans are very different, trauma is very different, backgrounds are very different, right? So while that was a great foundation for me as a learning clinician, as a learning leader, um it's not, it's not gonna fit everyone. So what I noticed at Gentle Path, and and this is a recent thing that we've done, right? So a recent story came up about it. Um I had a gentleman at my facility that just could not follow the rules. Could not. Like he wanted to save his marriage, he wanted to save his family, he wanted to get better. And the rigidity of that program couldn't keep him there. And I had already known Michael, a balion, I had already been referring. And so I'm like, look, this guy's getting kicked out and he's gonna die. There's a big risk of suicide for him, he's gonna lose his family, his kids are gonna be without a dad. The you know, this is a big thing. And I remember calling Michael and they took him. Um and he was still a pain in the butt for them. Uh, but he did work there. And before Christmas, Michael got a card from his 10-year-old son thanking him for saving his family and sending money to help anyone else that may need that help. And from a 10-year-old perspective, like that's amazing. So for me, that taught me that the rigidity was not the important part, the foundation was the important part. Finding a place that could customize with boundaries, staying in the foundation of that type of treatment is the most important part. Yeah, you gotta find where you're welcome, where you feel comfortable, where you can do the work at.

SPEAKER_06 12:48

That's good. So good. Let's talk a little bit about why sex addiction is maybe missed or or even misunderstood. Um, so why do you think that sex addiction remains one of the most misunderstood or under identified issues in the clinical and the medical setting?

SPEAKER_01 13:05

Um, for me, I think it's twofold. One, it's shame out of the client. Um there's still that misperception that it is a moral failing, not an addiction or a disease or based out of a traumatic experience. Um, and the other part, which I think is the one that I would like to talk more about today, is either the bias of therapists doing the work or the uncomfortability of talking about sex in the session with the client.

SPEAKER_06 13:38

Yeah, it's good. We'll get into that. What are some of the common ways that you see clinicians unintentionally minimize or mislabel what is actually sex addiction?

SPEAKER_01 13:48

I think my favorite one is they just have a high sex drive, right? He just has a really high sex drive, or uh, or the wife has a really low sex drive. So he must be seeking things outside of this because there must be a problem within the relationship. When obviously that can be true in some relationships, but it's not true in all, right? So there could be a really great, there could be nothing wrong with the wife, and there could really be nothing wrong with the man's sex drive, but the lack of intimacy and that that avoidant behavior will push them in a different direction because that's more comfortable than seeking the intimacy with somebody who they love, care, and actually have like a fear of somebody leaving or walking away.

SPEAKER_06 14:31

Yeah. Let's talk about that just a little bit more. Because when a client presents with anxiety or depression or even relational chaos, what should alert a clinician to look beneath the surface?

Rigid Models Vs Personalized Care

SPEAKER_01 14:47

I mean, that one's hard, right? Because that that could be anything. Everyone comes in with depression, anxiety, relational issues. Um I think for me, the thing that I like to look at the most is if you see them thriving in everything else but relationships, there's a bigger issue. You've got a CEO there who's been successful in every business career he's ever had, right? You've got family members who believe that there's nothing wrong, that that there's that this is not their problem. I don't even know why you're going to therapy. Um, and the only one that's concerned is the wife, where she's like, something's wrong. Something's missing, something's not happening, right? And then he's like, I don't know what you're talking about. I'm home every day at five o'clock. I pick up the kids, I do, and she's like, but something's missing. I don't feel it. I don't feel your presence. I don't feel like you're connecting with me. Or when you do, it feels insincere. That's the part where I start to dig a little bit deeper, right? Because if you can be successful in other, you don't see that in any of other addictions, right? Gambling, we're gonna see issues with money. Gaming, we're gonna see issues with work because they're up all night, right? Substance, we're gonna see issues with legal, we're gonna see issues with work, we're gonna see issues with relational. When it comes to sex addiction, like a lot of it is hidden. It is, it can be the longest hidden addiction that I've ever seen.

SPEAKER_06 16:27

So good. That's awesome. So let's switch gears for a second. Let's talk about identifying sex addiction addiction in the key criteria. Um, so when you're doing an assessment, what are the core signs or criteria that help you differentiate sex addiction from like what you were talking about earlier, like high libido, uh, situational risk taking, that kind of thing?

Why Sex Addiction Stays Hidden

SPEAKER_01 16:47

Yeah. So, first, you guys, I uh you all know sex addiction is not in the DSM, right? It is getting researched. We've done a ton of research. I actually am a board member for um AFAR, which is American Foundation for Addiction Research. And our focus this year has been on getting sex addiction into the DSM. It is now in the ICD 11, which doctors aren't quite using yet, right? Um, but it's there, which is the first step for us to getting in into the DSM. So, what we want to look at is the same way that we look at any other criteria for addiction, is we want to take some of those 10 key criteria and we want to make sure that at least three of those are met. So, from the studies, what we look at is we're looking at uh recurrent failure to resist sexual impulses in order to engage in specific sexual behaviors. We look at the frequency engaging in those behaviors to a greater extent or over a longer period of time than intended. So tolerance buildup, right? Persistent desire or unsuccessful effort to stop, reduce, or control these behaviors, so an inability to stop doing them. Inordinate amounts of time spent in obtaining sex, being sexual, or recovering from a sexual experience, preoccupation with sexual behavior or preparatory activity, frequent engaging in a behavior when expected to fulfill occupational, academic, domestic, and social obligations. I'll be honest, the social obligations most of the time is the thing that I notice gets missed. Everything else is pretty much there. Their work stays on point, their families don't see them miss a whole lot of time either. So that one is harder to get. And most of the time, by the time that one is triggered, it is very serious. And we're looking at somebody who is on the verge of suicide. Um, continuous, a continuation of the behavior, despite knowledge of having a persistent or recurrent social, financial, psychological, or physical problem that is caused or exacerbated by the behavior. The need to increase the intensity, frequency, number, or risk level of the behavior in order to achieve the desired effect or diminish effect with continued behaviors at the same level of intensity. Giving up or limiting social, occupational or recreational activities because of the behavior, and then, of course, distress, anxiety, restlessness, or irritability if unable to engage in the behavior.

SPEAKER_06 19:18

If someone wants that, can they come up to you afterwards and take a picture of that or something? Because my ADHD about halfway through took me to bowling tonight.

SPEAKER_02 19:25

Yeah. Okay.

SPEAKER_06 19:27

That was a lot. We got a question here. Great.

SPEAKER_04 19:29

So, like with the the missing out on uh things or the getting up on three two different categories for that, um, and they all both say like social and occupational. Could it be like instead framed as I'm not missing out on meeting with the like people that I care about because I believe formed a social world?

SPEAKER_02 19:55

Is that a different like way to that?

SPEAKER_06 19:58

Solid question.

SPEAKER_01 20:00

I would say sometimes. Um a lot of the times this is like a second life, so it doesn't integrate with their current life. Um, this could be I'm married with children and I have this side world that nobody knows about. And that's a big difference too, is the spouses, right? So a lot of times we look at addiction and we say there's enabling behaviors, the codependency, this and that. Spouses are not the same when it comes to sex addiction. They really don't know. They have no clue what's happening. And when they find out, their world has shifted completely upside down. They thought the sky was blue and now they realize it's green. Um, and it's it's a huge trauma for the spouses. So um that would actually be probably more healthy sexuality, right? If the things that I'm doing, I'm engaging with, I'm not shameful about them. They're a part of my everyday world and my behavior, um, versus sex addiction is very secretive.

SPEAKER_04 21:10

I'm also thinking like in that uh with like clients who are you know not monogamous, not in a monogamous relationship, like how that might present, or maybe clients who are in a non-monogamous relationship, how that might present maybe differently from in a monogamous like long-term relationship.

SPEAKER_01 21:31

Yeah, we see that a lot with our uh what we call meth and men or chemsex. Um in the LGBTQ world specifically with men, there are more relationships that are open where they will invite other people into their relationships. Um, what you'll notice is the rules, they'll still violate the rules because there are always rules set up to protect both. Partners in that relationship in this open space. And when those rules aren't getting met, it's the addictive part that's pulling them away from it.

SPEAKER_06 22:11

That's good. Yeah. While we're kind of any other questions while we're kind of pause here, I know we're throwing a lot.

SPEAKER_07 22:29

What you said is a lot of things weren't idle here as an issue, but it was so how do you tease apart what's in behavior, what's an addiction behavior, how would you treat them?

Clinical Red Flags And Core Criteria

SPEAKER_01 22:42

That's a that's a great question. Um it's very hard sometimes, right, to tease those out. For me, I'm looking at for offending within sex addiction, because there is a lot of boundary violating and offending within sex addiction that can pop up, especially as we start to get intensity seeking, as we start to get more of this risky behavior. Um, I've noticed that the offending within sex addiction really has to do with the trauma. So we're gonna look back at early childhood trauma. And what I've noticed in sex addiction is it is eight to 10 years old or younger, um, typically where I see most of the offending work come out as I get older. Uh, and it's because there's a skew in the arousal template, right? Our brains aren't formed yet by that age. We don't quite understand sex and what it looks like. So early exposure to violent sex or any type of pornography at that point, or even just sexual assault at that age, we don't, we can't make sense of that. So then it takes the arousal template, and what it does is it, it, it makes almost like when when victims of sexual assault say, but I was aroused by that. And it's like, but that wasn't your fault. That was a physical response. At that such early age of childhood, really now it is skewing that arousal template for them to believe that that is what they are aroused to. That is a part of what their arousal template is gonna have moving forward. So um, I look at that. I look at the trauma. Does the trauma make sense for what they're doing today? So if I was exposed to childhood pornography as a child, am I now watching childhood pornography as an adult? And is it related? Is it trauma repetition? Am I just repeating what I had as a kid? And if I am, then we need to look at that trauma and see if that's the driving force of it, right? Um, do I actually get dopamine hit or arousal or enjoyment out of the pain of somebody else? Right? Or again, am I just repeating my own trauma or trauma that I've experienced or witnessed, right? Those are the things that I pay attention to. Now there's no test that we can be like, oh, this is an offender without addiction, and this is an addiction with offending behaviors. But I think, you know, you've done it so long, right, within the criminal system. You start to, you start to look at all of the stuff, right? We look at psycho psychological testing. Do they actually show up for are you? I mean, you are they looking psychopathic, right? Or are we, are we worried about that? Do they have the dark triad? Are we right? If they have those things, then I would lean more towards I'm gonna treat them as an offender. And then I may mix some stuff in there for behavioral modification as I wouldn't an addiction. And then if it's the other way around and I see some significant trauma, then I'm gonna treat them as an addict and then I'm gonna weed some stuff in there for offending behaviors, right? Because I got to do both. I have to treat the trauma and hold accountability because either way, I've got to protect that client and society if there's offending behaviors. So great question. That's a great question. Did you have one thing?

SPEAKER_04 25:57

I did. Um to what degree is sex addiction inclusive? Um, increasing problematic orthographic viewing and masturbation. Does it have to always involve a partner, a live partner? I'm kind of curious about how you view the bigger sort of range of behaviors.

Secrecy, Non‑Monogamy, And Rule Violations

SPEAKER_01 26:26

I see sex addiction as like an umbrella, right? And then there are these pet the pegs that come off, and those are the behaviors, right? Um, a lot of the time what I see is sex addiction starts with pornography, which is so sad because nowadays our kids get access to it so early. And what was considered the dark web, even back when my old I have two generations of kids, by the way, I know, a little bit crazy. Uh so I have a generation 26 and 21 who are parents now themselves, and I have a nine-year-old at home. So uh my 21-year-old son, who's a Marine, he'll tell me what he had access to as a kid, right? Because he's so scared for his nine-year-old brother to have access to what he knows will be a hundred times worse than what he had access to. And back then they had to access the dark web, but they're all so smart with technology nowadays. They just, it's like at two, they figure out how to get into it. And we're still struggling to teach them it, right? Um, so pornography typically starts it off. What I've noticed is more radical, offending, violent pornography at a younger age accelerates the behaviors much quickly. Uh, and offending behaviors will show up before most of the time before they're 18. Um sometimes you'll have just a pornography addict, but by the time they're 30, 40, 50, now we're reaching into some illegal pornography because the tolerance level, the dopamine hits aren't as high anymore. And so now we've got to seek out that intensity. We've got to seek out that risk-seeking behaviors, right? Um, but most of the time you'll see pieces of each part of the umbrella somewhere in their behaviors. I rarely will find it. And even the guy's like, no, I'm just a porn addict. I'm good. I just watch porn. And it's like, let me talk to your wife for a moment. And it's like, has he ever violated your boundaries? Have you ever said no? And has he pushed it too far? And they're like, yep, more than once. I'm like, okay, so now we've got some boundary violating in there. And this has actually gotten physical, it's not just pornography, right? So for me, it's it's it's a combination, and um and it's sad that it all pretty much starts with that pornography base.

SPEAKER_04 28:56

What other common fees or whole kind of disorder do you see?

SPEAKER_01 29:08

Um deprivation. Most of the time of love, not of items or things. Um I'm trying, it's it's heartbreaking to be honest, when you hear these guys talk about the level of deprivation, because they could have everything. Um, my favorite book that I use within sex addiction is called The Golden Ghetto. Um it is about getting everything you possibly need. You have the roof, you have the food, you have the money, you have the access to whatever you could ever need, right? But um, you've had five different nannies. And they've been fired for different reasons. Or um, or mom is highly depressed and can't get out of bed. Um, and so she's not showing you love, and you're the one caretaking her. Um, it is a lot of that, the deprivation, ameshment, um parents who are emotionally avoidant and distant. So they become emotionally avoidant and distant. Um and then that puts them kind of in risky situations as well, right? So then they're seeking love from people who could use them, could abuse them, and then they find themselves with trauma. Yeah.

SPEAKER_06 30:32

So good. Yeah.

SPEAKER_04 30:33

Hey, uh super basic question. So um I really respect people using the terms that they identify with and what makes sense to them. But when I come from the SUD world, we're so reluctant to use the word addict or alcoholic on someone other than folks self-identifying. What's the language like if it's around? Because I haven't worked in it at all, and I don't know uh how to use terms without um stigmatizing or um you know assigning change.

Offending, Arousal Templates, And Early Trauma

SPEAKER_01 31:05

I mean, that's a great question because I think you probably get the same problems that we get, right? Where if we label it as addiction, it automatically pushes them away from doing work with us. And so instead of talking about, I mean, we'll talk about this could this is an addiction. These are the things that that you do that are unhealthy for your life. I really do focus on intimacy disorders. I talk about the lack and ability to connect with other humans in a healthy, productive way. I talk about uh that fear that comes up in intimacy disorders that if I were truly seen, I would be rejected or not loved or alone, um, or people would see that I'm a fraud. Um, I talk about the avoidance of being able to connect when somebody does want to connect with them. And when I start talking about that, what I notice is is they can relate to it. And then they start pulling in. And then once they start pulling in, then we can start working on language of addiction and recovery and sobriety. Um, and sobriety is very different. I think when people hear addiction, they think, oh my God, I have to stop doing this all together. It's like, what world would we be in if I told you you could never have any type of sexual part of your life? Um, people would just not get sober. Um, it would be unrealistic. So instead, it's more about how do we navigate this conversation in a healthy direction? So I don't worry too much about the labels unless I'm looking at like offending. And then I then I really do kind of focus in on it because I need them to understand that this is not just something that they're doing to themselves, but this is a way that they're harming others.

SPEAKER_06 32:50

Could I make a comment on that?

SPEAKER_01 32:52

Absolutely.

SPEAKER_06 32:52

Do you mind if I share how we met, Dan?

unknown 32:55

Oh, of course I can.

SPEAKER_06 32:56

So when I got to Valiant, um, I had been a pastor for 20 years in Nashville, grew up in a pastor's home, had no context for addiction, intimacy disorder, sex addiction, none of that. So I really appreciate that question because I felt so much compassion. And what came up uh in me when you said that was a lot of gratitude that you would even care to ask that question. Because when I first got the treatment, they were talking about sex addiction, and I just I couldn't relate to, I didn't know what they were talking about. Because in my mind, of course, I'm in total denial. I don't even know I'm an addict. I'm like, what am I doing with these other guys? They're really fucked up, messed up. And um I don't belong here. Of course, by the end of my 90 days, I'm like, I'm the worst out of all these guys, you know, by the time I get to it, right? Um, but I so I meet uh Dan here on the front row. Um and when we met, I'm I'm trying not to get emotional, but when we met, he shared some of his story with me. And I was like, oh, that's that's me. It's in it's intimacy disorder, it's love addiction. I wasn't acting out with prostitutes and all the different things. I couldn't, I couldn't identify with that. And so I think it was really helpful for me to meet Dan, who's become a brother to me, um, and share that story. And now I have more context for it. I'm I'm actually more comfortable with the word addiction now, but in the in the beginning, I felt so much shame around that. But intimacy disorder, even the word moral failure, the the phrase moral failure is used so much in the church. And I want to be like, we're all moral failures. What are you talking about? I just got caught and I was on a stage. You know, it's like, what you know, that type of thing. And so I I thank you for the compassion in that in that question. I I really related to that. Anything else, question-wise? Because this is we really want you to get out of the session what you want, right? So I like this better than my questions back here and then over to you.

unknown 34:49

Can you talk a little bit about women?

Pornography’s Role And Tolerance Escalation

SPEAKER_01 34:52

Oh, yeah, yeah. It's so I'll be I'm gonna give you a little bit of a disclaimer. Um, I don't do a lot of work with women. Um, and what I mean by that is like none. Um, I in the last seven years, all of my treatment centers have been solely men. Um prior to that, I can look back now after having the training that I have and I can recognize the addiction that came up in women that I wasn't able to know because I wasn't educated to pay attention to it or to look for it, right? But it it shows the same way when we're talking about trauma repetition, right? It is it is that that person who's been raped and now I'm becoming promiscuous and everybody's judging me because, oh, was she really raped or was she just out there sleeping around with people? And it's like, no, she was raped and now she is trying to find control for herself. She's trying to replicate that trauma so that she can change the story and the narrative in her head, right? It's some of the same things our guys do, but our women do it too, right? Or they become what is the opposite of what we think about sex addiction, which is sexual anorexia, which is now I have no sexual desire, I have no sexual wants, um, because that's the only way I feel like I can protect myself from being harmed again, right? Um love addicted, love avoidant. You had made that love addicted comment that is common that I see through women. Um, women really are seeking, or anybody, men, women, whoever, when they get into sex addiction, are seeking that validation, that connection with another human being. And so some people have only been taught that they can do that through sex, sexual acts, sexual behaviors. They don't know what it's like to actually be vulnerable, open up themselves so that they can receive another person and connect in a way that is truly healthy in connection, right? So I think I see those three mostly within women when I have looked back at my time working with them. And that's the most concerning because they put themselves at great risk of any of them, right? So we're either going to go into no connection at all and feel completely lonely. We are going to overly try to connect sexually with other people in a very promiscuous, risky way, because we tend to seek the same people who abused us so that we can make sure we reduce our chances or we can control the narrative or change the story. Um, or we're just constantly trying to seek love through sexual acts, which we know is just not gonna happen, right? Um, again, we got to get back down to the trauma, help them understand and see what's driving those behaviors, what they actually want, and then start to show them like the behaviors you're doing are not gonna lead you to what your your goal is and what your intent is.

SPEAKER_06 37:46

Yeah. Thank you for asking that that question. Back over here.

SPEAKER_02 37:50

Uh I was gonna ask a really similar question. So are those the three kind of templates for all gym lips, or is there a kind of difference?

SPEAKER_01 37:57

I've noticed those are more three for females when I look back. And in, you know, when you start to learn something new, you sometimes look back at those at those ones that you're like, oh, I was really fond of them, or I remember them, and like, what did I miss? Um, and those are the things I noticed the most was those are the things that I missed in the female population when I was working. Um it's hard to talk about what could be more today, just because I don't do a lot with females. Um, but I do know that there is still those three main categories. I have a couple friends that are are working primarily with females, and and that's the three things they talk about the most.

SPEAKER_02 38:40

What about with men? Is it similar categories or totally different?

SPEAKER_01 38:44

Um, men, I feel like because I'm just enthralled in it every single day, I can see all the little pegs that come down. Um so I mean, I could probably talk all day long about the different pegs, and because it could be power and control, right? It could be um it could be dominance, it could be being dominated, it could be being harmed, right? Again, that trauma repetition, all we're doing is we're looking at what trauma are they trying to reproduce and control.

SPEAKER_06 39:16

Great, all the way in the back.

SPEAKER_04 39:18

Yes, I may have uh already addressed this, and I apologize for something you might have on. Can you speak to um I don't know if they still call it swinging, but that particular lifestyle in terms of how that looks for sex addiction?

SPEAKER_01 39:36

Yeah, yeah. So um we have this saying, and it's it's mostly in the sex addiction therapy world, but it's I don't yuck anybody's yum. It's the best way I could put it.

SPEAKER_08 39:51

I love that.

Deprivation, Attachment, And The Golden Ghetto

SPEAKER_01 39:52

Um, because there are healthy sexual activities that couples can do that people can do, that is not necessarily sex addiction. It could be something that I'm not fond of, that that maybe most people aren't fond of. But if it is done in a healthy way that is not used out of trauma or not used to harm somebody else, or we're not violating people's boundaries, then I'm not here to judge for that, right? So there are worlds in which in which swinging would be considered somebody's yum, right? And that would be if both partners are consensual to it. Um, and I want to get down to that, right? It's not the wife is so scared she's gonna lose the husband, she's consenting in order not to lose the husband. That is not healthy swinging, right? Healthy swinging would be the wife also wants to engage in these behaviors. They have set up parameters for what that looks like and they respect one another's parameters, and that's how they live their life, right? Um, once we start stepping outside of those parameters, once we start using it for a numbing, for a dopamine hit, for a trauma response, for coping mechanisms. Now we're looking at something that becomes unhealthy.

SPEAKER_04 41:11

So I I yeah, I I I didn't see where you're coming from, but there's more involved here because oftentimes there's children that are affected by this behavior. And when we talk about sex addiction, uh any other activity. I was just wondering if this is something that that's come to your attention and that's problematic.

SPEAKER_01 41:37

Oh, we whenever it pops up, we're always going to investigate it, right? Because again, that's if their children are involved in a way that their kids know about their swinging, that's not healthy, right? That's not that's not something that their kids should be involved in. Um, that is should be something that's private for the bedroom between a husband and a wife. Um, if it is that, you know, they're getting a grandma and grandpa to watch the kids for a weekend and they go out on a trip and they're doing this behavior intentionally with rules, that's a little bit different. And they're not doing it every weekend, so their kids are missing them every weekend. I think it's more about balance. When we look at addiction, addiction's never balanced, right? And there's always somebody harmed. So if a kid's getting harmed in their swinging behaviors, I would lean towards that's being problematic and an addiction.

SPEAKER_05 42:26

Yeah.

SPEAKER_06 42:27

You had another question?

SPEAKER_04 42:28

Well, I'm kind of this is like one B to us.

SPEAKER_06 42:33

I like it.

SPEAKER_04 42:34

Because perhaps in this scenario, it becomes a matter of degree. So because I would posit that most people who engage with behaviors, sex, or whatever, as a trauma response in an effort to not don't yet have the reflective ability to recognize that that's what's driving the behavior.

SPEAKER_01 42:55

Oh, 100%.

SPEAKER_04 42:57

So I think it's yeah, a very slippery slip.

SPEAKER_01 43:02

Right, which is why we've got to dig a little bit, right? So it's like, is the wife actually consenting? I've had a few come in and they're like both.

SPEAKER_04 43:09

We like have gone home, but that doesn't mean it's mutually exclusive of the fact that it's driven by some deeply problematic motivations.

Language That Lowers Shame And Opens Work

SPEAKER_01 43:23

Yeah, absolutely. It's just doing deeper work, right? Um, and I have found by the time um, let's say a hut, because I always deal with more of the husbands, right? By the time the husband comes into treatment, even if they were gung-ho together, by the time we're getting on the phone with her, she's starting to recognize that, you know, I wasn't always happy about this. It took him five years to get me to agree to this, right? Or I agreed right away, and then something happened and I didn't feel right about it. And it's like those little things. Exactly. Little pieces come up of this doubt of that this was actually something I really wanted to do. And that's when we're like, okay, let's get you a therapist. Right. Because we need you to do your own work too. Because there's something popping up over here that's allowing this to continue. And you feel like you're, or he feels like you're an active, complicit consensual partner in this, but this is not what I'm hearing now. Right. Yeah. Absolutely.

SPEAKER_06 44:28

All the way in the back.

SPEAKER_08 44:34

What is the upper care?

SPEAKER_01 44:49

I'm actually gonna pass that to Drew right here. Um well, look at the time. So Drew is Drew is he's the head of our alumni right now. So um I think that's a great question for you for you to go through. Personal experience and you know, actively engaging in valiant living's model of accounting.

SPEAKER_06 45:15

Yeah. So I think the way I'm wired is I wanted to just I wanted to go to treatment and I wanted to fix it, and I wanted to go back to being normal.

unknown 45:26

Whatever normal.

SPEAKER_06 45:28

Right. The setting on the washing machine or the dryer, whatever. Um, yeah, I mean, for me, it's like, you know, I'm uh I think three and a half years into recovery, and it's still working my program and staying connected and talking to my guys, and we zoom every Tuesday night and every Friday morning as part of our alumni program, and we go on retreats together, and I call them when I'm struggling, and we text them. I mean, it's just like it's the stuff y'all teach us to do and on day one. Like we're still doing it on you know, day 100 and day 300. You know, it's like to me, that's it. I mean, it's it's it's the the phrase that I love that you guys use so much is that um addiction about connection and addiction. The opposite of addiction is is not sobriety, but it's it's connection. You know, it's like I think I said that wrong, but you get it. Um so that's for me, intimacy disorder was I had no ability to stay connected to my emotions and how I was feeling. Uh, a great resource that is he was actually my therapist and my interventionist is is a guy by the name of Chip Dodd, and he wrote a book called Uh Voice of the Heart. And he talks about the eight core feelings. And it was helpful for me to go through and just be able to name like anger was always taught I could get to anger quick, but I couldn't get to sad. Like, I'm at seven on the Enneagram, so sadness was like, what's that? I've never felt sad in my life. I just escape and run. And if I stay out in front of it. So, I mean, to that point, aftercare for me has just been continuing to follow the program, continue. Um, I used to say Valiant save my life, and they corrected me and they said, No, we gave you the tools to save your life. And so that's if I don't use those tools, I'm gonna go back into my addiction. I'm gonna go back into intimacy disorder and I'm gonna continue to make decisions that harm myself and my family. But if I use those tools, I continue to show up and I stay connected to my brothers and and all those things, then I can live every day in in uh in freedom and in peace. And and I could have been wrong about all of that. So just about it.

Aftercare, Brotherhood, And Daily Tools

SPEAKER_01 47:23

I think I think he's 100% right about that, right? It's it's the same as any other addiction, right? They just got to keep doing the work. That they're not, I always tell them, you guys aren't cars. You didn't come here to get fixed. Healing is a process, right? So it's I don't just take the tire off, replace the brake pads, and now you're good to go. Drive on your way. It's we're actually working a process. So, like you would your substance guys, make sure you have a therapist on board, make sure you have, you know, a network that you can talk to, which is what Drew's talking about. His, his, his guys, his his brothers, the alumni. Um, that's why we keep our alumni program going. And I have alumni running it because they can relate to one another, right? Um and I think for sex eviction, group work is some of the most important because that shame will hide in individuals every single day. So the more they're in group talking with one another, the more they're relating to one another and saying, brother, I've been there. Like I hear you struggling right now. I was struggling last week. Like, great job. Thank you for calling me. Let's talk about it. The more it releases those secrets and that and that shame, the better that that they are.

SPEAKER_06 48:42

Yeah. And I have to have a place to call myself out on my bullshit. I mean, that's just what it is. I have to go to that place. Um, when I was at Valiant, I was going back and forth from Denver back to where I live in Franklin at the end of my treatment to start integrating back with my family some. And it's really kind of a miraculous story. And my wife is a total hero and it's chose to do her own work. I mean, it's unbelievable what she's done. Um, but as I was going back, I went to an essay meeting downtown. I went there, there was like 60 guys there. It was super intimidating. And I felt myself doing the same old stuff. Like I was networking and I was like, who do I need to know in this room to help build my next career and all this kind of stuff, right? So I go back and I tell my therapist, who was Stephen Spinotto at the time, and I tell Stephen this is what's going on. And Steven says, That's okay. I mean, that's that happens. He's like, You're going back in a couple weeks, but when you go back, I want you to do a share and I want you to call yourself out on that bullshit. And I was like, You have got to be kidding me. I am not doing that. But then he told all my brothers in recovery, so they're all gonna hold me accountable when I came back. And it was the best thing I ever did because I literally just told them what I just told you. I was like, I'm here doing the Nashville thing, trying to work the room and who should I get coffee with? And I gotta be here for my own recovery. And the funny part is it it kind of like was reverse psychology because they all were like, Oh yeah, me too, and let's get coffee. And I was like, No, I can't remember. I just told you I don't want to do that. Um but that's that's why I still go on Tuesdays and Fridays, because of things that I really can't tell anybody, I can tell those guys. And then it just kind of you know gets it out here, so it doesn't, when it gets outside of me, it's it's it's helpful and I can deal with it. It's good stuff. Any other topics or questions? Voice of the Heart by Chip Dodd. He's written a lot of um great resources um on addiction that my wife read and I read, and it was extremely, extremely helpful. He's amazing. You guys raised your hand literally at the same time. Let's go right here, right here to the right.

SPEAKER_01 51:03

I I mean for me, um when they're doing group work, what I like to start addressing is kind of what Drew said. Like, did you do anything this week that took you outside of who you want to be? Do you notice any old behaviors popping back up? Were you in a moment where you thought for just a second, if I don't behave in this way, this person's gonna walk out right now? Right? The biggest fear I've ever seen come up in sex addiction is abandonment, rejection, um, failure. Most our sex addicts are highly successful when you look at them from the outside. So uh we all know what it feels like, or at least I'll say I know what it feels like to have imposter syndrome at times, right? As we're starting to become therapists and we start working into a career, you know, we want to do really great things, and then we walk into a situation where we're like, oh my gosh, I don't know if I'm ready for this. Um, but that has been the what I've noticed is one of the biggest fears that come up in our guys is that being put on display or having to be called out, right? Um, and because I'm not exactly what somebody wants me to be, they're not gonna value who I am, right? Um, so it's just continuously talking about that. Let's keep that as an open dialogue, let's keep talking about it.

Group Structure, Check‑Ins, And Safety

SPEAKER_06 52:28

We also keep our group meetings pretty structured. They're not like a they're not a 12-step meeting, but we do have an alumni creed that we read at the beginning. We've got some ground rules, like we don't try to fix one another. Uh, we ask if we can give feedback. And then when we give feedback, we only talk about ourselves. We don't try to fix them or talk about them, or we just talk about what came up in us. Um, trying to think what else. There is some crosstalk in our in our meetings. Um, we also at the beginning of every meeting, we asked, does anybody need the meeting tonight? So it's just similar to some 12-step, like some they might be extremely dysregulated. We had one guy um just show up last week and said he was literally counting the minutes to the meeting because he was gonna use, and he's like, I just gotta get to the meeting, get to the meeting. So we got there. We made the whole meeting about him that night because that's what he needed. Uh so we always start with that. Who needs the meeting? So there is some structure, it's you know, it's kind of pure pure rum. There's some structure for that, and then monthly we all get together in person in Denver and have like a speaker meeting and a dinner and all that, and then quarterly fun events, that kind of stuff. But we try to keep structure because we we addicts need it. So was there another one over here? Yeah.

SPEAKER_04 53:34

Um, so is it important that there's a choice in genders for providers? Um, do you feel like it makes a big difference when you're when you're offering this service that would then like be like I want to think it's more male identifying more female identifying?

SPEAKER_01 53:52

Um, I think if the client thinks it's important, then it might be important. Um if they don't think it's important, then I don't see much of a difference. Um, I think I can do the same type of work that Dan over here can do. Um there's a little bit of a difference to it. And sometimes I think just with anybody else's trauma, if there's maybe a corrective experience that needs to be done with another male, then maybe that male is the best choice, right? If there's a corrective experience to meet done with a female, he had a highly enmeshed mom or something like that, and he needs to learn how somebody can hold a boundary while still caring for them and being compassionate for them, then a female may be best. Um, but I think the work can be done with either. Um it would take the pri but I mean, you know, we also have to look at there is some LGBTQ involvement and be respectful of people's safety. And I think if somebody's coming in and saying, I need to go see a male, then there might be a safety thing that's popping up in that moment. Um, and so I would respect the safety thing first and then see how the treatment goes. A lot of times, um, sometimes that'll happen, and then Dan will be like, maybe the male's not the best for this right now, because uh he thought he could control the male better, or he could good old boy the male, right? And maybe he needs a female to step in and set some boundaries. Um, and then you just make an adjustment as that comes up, which is great for having a network of providers so that you can just, hey, I have this one case, let's see if we can consult about it.

Does Therapist Gender Matter?

SPEAKER_06 55:35

Yeah. Yeah, I my experience, I had a straight female and then a gay male in treatment. Uh, I grew up extremely conservative evangelical Christian environment. I think at first they placed me with the female who had more of a like a Christian background, I think. Um, and she was awesome from the standpoint of I needed to learn how to be uncomfortable. Like she was my first where I was actually starting to talk for the first time about my acting out. It was really good for me to have a really positive relationship with a female where there was great boundaries and she was really an authority figure, which I struggled with, all those things in the beginning. But then when I when I transferred over to Steven, it was super great because it really dismantled all of the stuff that all the stuff I built in my mind over the years of my childhood. And you know, Steven is here and he's I I love him. He's a he's a brother, he's he's a great friend. Came to Nashville recently, and so I I needed both. So I think there's there's value in both. I was actually glad that I got to experience both because I think I got really good but different things from from both of them. So, but that's just my my experience. Yeah.

SPEAKER_04 56:50

What are some of the specific interventions of the therapeutic approach that you provide for like a psycho education?

Psychoeducation To Experiential Change

SPEAKER_01 56:58

That's a great question. So um this is a newly developed curriculum at Valiant. Um, but the purpose of it was to take somebody through what we see in addiction, like cognitive distortions, um, family of origin, trauma, and essentially start off with the problem, right? How is this thing affecting your behaviors today? Walk them through a psychodrama, experiential, empty chair work, be able to give them some form of assignment where they can kind of look at it, and then have them understand how to do some correction towards what they've been doing, right? So um we took six to eight different topics and outlined the week just like that. So they get some education on what cognitive distortions are. They do um an experiential or empty chairwork psychodrama. Cognitive distortions is passengers on the bus. So they do an assignment called passengers on the bus, which actually kind of uh incorporates IFS into it too. So it's like which passenger is driving your bus at different moments. Um, and then they do an ass, which is that's actually kind of one of the coolest things that I love about that experiential is you like set up the chairs as buses. Sometimes their brothers will jump in because they'll be like, I don't know who took over my bus. And the brother will be like, What are you talking about? That was your eight-year-old kid. Move, I've got this. And they're like moving them out of the driver's seat, and they're like, I'll drive as your eight-year-old. Let me tell you what your eight-year-old was saying. This is not fair. Mom did this, you know, and they'll start speaking for the patient. And it's like, and then the patient's like, Oh yeah, yeah, I did say that, didn't I? Um, sometimes we do Cartman Triangle, right? Where it's like they'll play different pieces and their peers will go play the victim or the rescuer while they get to play the perpetrator. Um, and then they get to do that assignment where they're looking deeper into like what are their actual parts that come out? When do they come out? How can we stop them from coming out? How can we recognize that that eight-year-old kid's popping up and trying to drive my adult bus right now in this moment? Um, and so it's really just trying to not just throw education at them, but real life tools so they understand how it works in their life. And then how do we stop that, or at least how do we pause it for the moment so we can seek help when we notice these things come up? You're welcome.

SPEAKER_04 59:26

Are there any specific trauma modalities that tend to be more effective with this type of addiction?

SPEAKER_01 59:33

Yes, I have noticed um somatic experience works really well, um, especially in the men's population. The psychodrama, um, and then I have some background with the meadows, so I am pit certified, pit one, and pit two certified. And that has a lot of that inner child work to it. Um, because their trauma is from such a young age, I really believe that that inner child has to be freed, has to be healed, has to be safe. Um, I've noticed with our sex addiction population that EMDR is a little bit harder for them to get to that because our guys are very performative. Um, and you can be performative in EMDR, and it looks very much like progress and it looks like they're doing exactly what we're asking them to do. Um, but sometimes that can be a box that's checked if we're not really fully in tune with them. Um, so I've noticed the first things that I always try to work on is more of that somatic experience, working them through the body, getting them moving, getting them talking while they're moving. Um and for us at Valiant, that is really our wellness program. So we take them on hikes, we put them out in nature, we make them walk shoulder to shoulder instead of sitting in a group looking at each other in a circle. Um and I've noticed there are a lot of great things that come out of that, right? They are more free, they're more sincere when they're talking, they're more real, they can become more vulnerable without actually recognizing that they're more vulnerable.

SPEAKER_06 1:01:04

Um, they're activated and dysregulated, which was my experience after yoga every morning. They're like, I can't touch my toes. Why are you making me do all this stuff? But it was part of the work, you know, part of it was in the wellness was like, okay, well, let's talk about that. Let's, you know, yeah, I feel shame. Yeah, it was coming from. That just made me more mad, you know. It's like I didn't know that they were communicating through the ranks, so I'd get to the next group and they'd already told them that I was angry in yoga and they were ready for me for the next group. And yeah, it's good stuff.

SPEAKER_01 1:01:33

So yeah, we just try to get them moving first. I think for me, the second is really that psychodrama, getting them to experience it in a safe place with one another. And then then maybe we can look at like EMDR and then we can look at these other things because they're gonna be less per they're gonna see the benefits of actually working through this sincerely versus just checking the boxes.

SPEAKER_06 1:01:58

So good. The questions are awesome.

SPEAKER_01 1:02:00

Yeah, I love them. They're amazing.

SPEAKER_06 1:02:03

I think we have a few more minutes. Um, if you guys are good to keep going just for a second. I I got I got three different kinds of categories. You can kind of choose your own adventure because we're not gonna get around to all of them. I got childhood attachment and intimacy disorders, which kind of touched on a little bit. I've got treatment and healing, I've got countertransference and the clinician.

SPEAKER_01 1:02:21

Oh, let's do that one.

SPEAKER_06 1:02:23

All right, the whole room.

SPEAKER_01 1:02:27

That was you.

SPEAKER_06 1:02:28

I don't have the both the best emotional intelligence, but I could read the room on that one. All right. Why is countertransference such a critical conversation in this work?

Trauma Modalities And Somatic Work

SPEAKER_01 1:02:39

Oh my gosh. Okay. So um I have gotten calls from therapists before, and they're like, I really want to go over this case conceptualization. Is does my is my patient an addict? Does he need to go to treatment? I'm like, well, tell me more. We watch his porn. Okay. What kind of porn? I'm supposed to ask him that. I'm like, yes, please. How much porn? I don't, I mean, I don't know. How often? Um, I don't know. Is he masturbating to the porn? Oh, I don't, I don't know. Like what what happened here? Right?

SPEAKER_07 1:03:18

Yeah, exactly.

SPEAKER_01 1:03:20

I know he watches porn, right? She feels something, she knows something is off. She's recognized maybe that she's worked with this patient for 12 to 14 weeks. There's no progress. And now pornography comes up and the alarms start going off, but the questions stop. And for me, that's the big part. Why do the questions stop? Right? We've got to be comfortable being able to ask some of these really uncomfortable questions. Like, so what are your search terms when you're looking at pornography? Those are so important. There's a big difference between, you know, um, barely legal and um I don't know, MILF.

unknown 1:04:01

Right?

SPEAKER_06 1:04:02

You look way looking at me. I thought that was confidential. Just kidding.

SPEAKER_05 1:04:13

Yeah, yeah. That was great.

SPEAKER_03 1:04:24

We both do. Yes, yes.

SPEAKER_05 1:04:37

Yeah.

SPEAKER_04 1:04:59

It would not be right, but we're not bringing it. I think some of these tells us that don't really have even understand addiction in general. And that's why they're not asking more, you know, uh embolic questions.

Countertransference And Asking Hard Questions

SPEAKER_01 1:05:26

I I really wish that was always the case, right? Um, a lot of these are addiction therapists. And so the same way as you would ask, you know, how much alcohol are you drinking? What behaviors are you doing while on that alcohol? Are you driving with your children in the car? Um, are you are you working while intoxicated? Um, all of those questions are going to perchain when it comes to the pornography. So, are you watching pornography while you're watching your children? Right? Are your children awake when you're watching this? Are you doing it in a room in which they can walk into? Are you watching pornography while driving? Right. That becomes a big thing as well. Um, are you watching pornography in your car? Are you masturbating in your car while watching pornography in a public parking spot? What is what is that doing, right? So I think while yes, probably some do lack maybe the education of addiction altogether. I think some could be our own counter-transference of just because I've literally heard it. I don't think that's the place to ask them. And I'm like, you're doing therapy. This is intimate work. You know everything else but the search terms of his pornography. Why is that the one thing that you have deemed you don't need to ask? And that's inappropriate to ask. I think it's more just it's uncomfortable. It's uncomfortable and it's it can be sometimes uh a gender thing. If you're a female sitting in a room with a male, you're not used to doing this type of work to say what are the search terms that you're asked that you're searching right now for your pornography, or how often are you watching pornography, or are you masturbating to the point of injury? Those things can feel uncomfortable when we're doing them, right? But they're really important for us to be able to set up the best way that we can or find the best treatment we can for our clients. And I think even just not asking it, and you can you can tell me what you would think because if that would have happened to you when you were seeking help, would you have been less likely to seek help? Like I'm watching pornography. Oh, okay, and now I'm not right.

SPEAKER_06 1:07:30

I'm probably like, why am I here? That was the one, you know, like yeah.

SPEAKER_01 1:07:34

But it's like that's can we can we go into that a little bit?

SPEAKER_06 1:07:36

So, say we're in a session and you ask me that question about search terms, and I'm defensive and feeling shame, and so I don't want to say so. I'm asking you, like, well, why do you need to know that? What does that matter?

SPEAKER_01 1:07:47

So it helps me to understand what type of direction your sex addiction goes into or your pornography goes into. It'll also help me understand how you may engage with your wife that could maybe be harmful to the relationship. And nothing you're gonna tell me right now I haven't already heard, or I'm gonna judge. I just want to help you the best I can.

SPEAKER_03 1:08:08

Yeah.

SPEAKER_01 1:08:08

Right. So it's it's just opening up a space where I'm explaining to him exactly why that's helpful because it is, right? I'm gonna see, especially when it comes to like offending behaviors, right? I'm gonna see the difference between somebody who's watching rape pornography versus somebody who is watching pornography based off of a fetish. Um, I'm gonna see the difference between somebody who's watching illegal pornography, and sometimes depending upon what state I'm in, right? If I'm in California or Pennsylvania, I make sure I let them know ahead of time, or I don't ask some of these questions, um, but I let them know what would be a mandated report. Because in California or Pennsylvania, I don't need a identifiable victim watching child pornography in itself in California and Pennsylvania is reportable. So I make sure I lay those out first because my job is not to get him put in prison, not you specifically.

SPEAKER_05 1:09:02

Thank you.

SPEAKER_01 1:09:05

But my job is to figure out how I can help this person, right? And then I'm laying out is this is this criminal, is this, is this addictive? Um, and my job is to do the best I can to get him the resources that he needs to navigate that. Um if it becomes something that's criminal and they disclose it even after I have told them not to, then I mean now that they were warned, now I have to do what I have to do, right? Um if it becomes something where a kid's involved and now there's trauma to a kid, again, I have to follow my my own moral groundings and my own duties as a therapist and report and protect the children of the people being harmed. But my first goal is to make sure I get him the help that he needs.

SPEAKER_06 1:09:48

What's the percentage of people who are honest the first time you ask?

SPEAKER_01 1:09:52

Oh god. What do you guys think?

SPEAKER_06 1:09:56

So asking, ask and keep asking, right? Yeah, right here.

SPEAKER_01 1:09:59

Yeah.

unknown 1:10:00

Oh no.

SPEAKER_06 1:10:01

Did you blank?

unknown 1:10:02

It's a question.

SPEAKER_02 1:10:05

So you listed off a few behaviors that we would ask about. And as a person who hasn't thought to ask those questions, right? It's I wouldn't have thought about those behaviors and things that people are doing, right? Like, so it's just like, you know, like when you're not an addiction therapist, you don't think to ask if somebody's like injecting cocaine. Yeah, right.

SPEAKER_04 1:10:30

Like that just wouldn't have occurred to like uh a person who's never used cocaine that way. So is there like a list somewhere of like things that yeah, problematic behaviors or you know, you were like talking about you know, asking if they watchboard while driving like whatever go to meeting? Like, think about asking, right? Yeah.

SPEAKER_02 1:10:53

Or like assessments or things like that.

SPEAKER_01 1:10:56

Definitely assessments. So I have a list of assessments you guys can come take a picture of if you'd like. Uh, we start with the SDI. It is uh the sexual dependency inventory index. Did you change it to index? Okay.

SPEAKER_08 1:11:11

Um SAS, we usually go SaaS first because that's the shorter one.

SPEAKER_01 1:11:15

Um yeah, you could do this. I always just kind of start with the SDI. The SAS is a small is a smaller version. Um, but for me, uh, I think there's more workaround if somebody doesn't want to be seen or uh doesn't want to recognize or identify, and the SDI pulls out a little bit more information that you can use. Um and I wish there was a list. I wish.

SPEAKER_06 1:11:39

Um let's do a brainstorm group together. Let's make a list.

SPEAKER_08 1:11:51

Yeah. Yeah. It's got it's got some measurements in it that will help.

SPEAKER_01 1:11:56

Oh, this this guy's BS and inconsistent or exaggerating, minimizing.

SPEAKER_08 1:12:02

Exaggeration, minimization. Um, you know, all of those are are in the SDI that's entitlement.

SPEAKER_01 1:12:10

That's my favorite measure.

SPEAKER_05 1:12:13

Yeah, yeah, yeah.

Tech, AI, And New Access Pathways

SPEAKER_08 1:12:14

But that one is on what's called recovery. New recover new.recoveryzone.com. It does um there is a fee for for the SDI um through ITAP. Um and yeah, you have to buy tokens. That's got it. New dot recoveryzone.com.

SPEAKER_05 1:12:37

Thank you.

SPEAKER_06 1:12:42

Got it.recoveryzone.com.

SPEAKER_01 1:12:45

Outside of that, what I would say one of the biggest things that I've paid attention to is technology. So if they identify technology being an issue, even if that's gaming. So um, and you of course you learn these things as you get further into it, but it's like gaming. So, how many screens do you have? I'm like, I have three screens. I'm like, well, what do you need three screens for when you're gaming? Most gamers use two screens, like two big screens. Third one is either for pornography or gambling. Typically, I'll find it. Uh, if there's gaming as kids, uh, there's a lead into pornography, anyways. It's a weird gap right now.

SPEAKER_04 1:13:27

Scrolling because like I know a lot of people have like just like tons of porn on their Instagram service, okay.

SPEAKER_01 1:13:36

Yep, absolutely. So, I mean, I think in this day and age, we should be asking technology questions, anyways. Curious, what's your what's your relationship with your phone? How often do you have it? What do you tend to go to when you're on it? Um, do you spend a lot of time scrolling on your phone? What are you scrolling on your phone? Um it's I'm scrolling Instagram. What are you looking for? Is it for connections with friends and family? Are these random strangers you're looking into? What does that do for you? How do you feel after that? Um just a lot.

SPEAKER_02 1:14:11

Why does it sound like work?

SPEAKER_01 1:14:15

Yeah, yeah. So I mean, technology for me is the leading into looking closer into sex addiction.

SPEAKER_04 1:14:24

I'm through this conference a lot about paying chat boxes that are about sex.

Attachment Patterns And Personality Traits

SPEAKER_01 1:14:36

Yes. Yes. Um, it's it's actually getting this is like the new the VR systems now can actually do more virtual pornography. Um, and so kids are getting into that system a little bit easier nowadays. Um, the AI can actually pull up erotic novels and descriptions or fantasies. So if they go into AI and they say, develop a fantasy for this, this, and this, the AI is is developed to go ahead and do it. There are some protective measures that have been placed in AI to help with more offending behaviors or um recognizing when somebody's asking for a child to be involved in this fantasy and they'll get kicked out of the system. But I'm as with everything else, there's always a bypass that uh most people can get through. So AI is a big, big thing coming up. It's yeah.

SPEAKER_07 1:15:30

Yeah, look here.

SPEAKER_04 1:15:32

Um, I am primarily a psychodynamics and parent. So fine. I'm gonna take us from a tactic to talk about object relations, but you you talked a bit about drama and about the role of seeking intimacy. And I'm wondering if you can sort of encapsulate correctly what you see in terms of attachment style object relations from early life. And you know, of course, there's a lot I work with a lot of different forms of addiction. So there's a wrap addiction. Oh yeah. Um but I'm wondering if you see patterns and you know, I I'm thinking of a client who was a female who was incredibly sexually driven and had a significantly borderline personality organization. So it gets work.

SPEAKER_01 1:16:47

Yeah. So when we're looking at attachment styles, 99.9% are that fearful avoidant personality style. Um, when you're looking at personality traits for men, it leans on, and I would say more, maybe 75% are that narcissistic uh uh flair with antisocial.

SPEAKER_04 1:17:14

I mean, not not anyway here.

SPEAKER_01 1:17:16

No, no, no, they're alive. Well, and you know what the the interesting thing is, right, when we're looking at trauma and we're looking at personality traits that show up through trauma, is you know, when I was taught it was if there is a significant trauma traumatic event or if we're seeing personality traits from different personality styles, and we can't actually diagnose that because the personality is coming out of the resiliency of the trauma, right? So I tell a lot of the wives will call me, but is my husband narcissistic? And I'm like, well, you tell me, tell me what it was like, right? Give me your experience, and then let me tell you this. I can't, I can't test him right now. That's not fair. Addiction is narcissistic, right? In itself, addiction is narcissistic. I'm I'm seeking this thing for my own pleasure, right? So let's get him a year sober and then you want to ask if he's narcissistic, then let's go through this question if he's narcissistic or if he's antisocial, right? But for this first year, let's get him sober first. Let's see some clearing of the brain. Let's see what traits linger after we've done some work on the trauma, right? Um, but yeah, the fearful avoidant, it's they're always in that. And the SDI actually measures the attachment style within it. And so it'll show you where they land on the attachment style. It's all part of that pro. It's it's great. Yeah. So 100%. Um, and our women, I do see tend to see more historianic borderline traits that pop up. But I will tell you, about 25% of our guys that come in also do have some histrionic borderline or dependent traits that that tend to be more of their driving force. So I see more consistency with females and what that looks like than I do with men. It's more, it has a broader range.

SPEAKER_04 1:19:05

I need you, I love you, but stay over there.

SPEAKER_01 1:19:08

Yes, that's that love addicted love avoidance. Yes.

unknown 1:19:11

Absolutely.

SPEAKER_01 1:19:12

Yeah, yeah, absolutely.

SPEAKER_06 1:19:15

Right here in the middle, and I'll come back over here. Yep.

unknown 1:19:17

Hi, Drew.

SPEAKER_06 1:19:18

Hi. I'm so sorry I'm late to your uh lecture.

SPEAKER_04 1:19:21

Notice that I apologize in covered this, but I'm curious as to if you were working with a male client who um has an FUD as well as a sex addict, and how important is it to you to unravel like which came first? Like as far as like as far as trying to discover what the other traits are that are underneath the whole thing, right? As you unweave the whole thing, like how do you approach that as like a whole, if that makes sense?

Meth, Chemsex, And Grieving The High

SPEAKER_01 1:19:57

Yeah, I think um for me the thing that I focus on the most is have they intertwined, right? So, like for me, is it now meth and sex? If it's meth and sex, like we've got a pretty serious situation, right? Because we've got the number one drug that causes the most dopamine hit, and we've got the number one behavior that also causes the most dopamine hit. So them together is like outrageous dopamine, right? And they're never gonna get back to that and they always want to. And a lot of the times these guys or women can't see sex without this meth now, right? And can't see meth without the sex. So they're so entwined that I really can't pull them apart anymore. So from this point, what I have to do is is I have to allow them to grieve that this level of dopamine is not healthy for them. And then work on the trauma that pulled them towards that, anyways, right? Because I'm not, I'm not gonna be able to separate the two anymore. They're they're combined, they're done. And that will that that will kill our patient. Like they will, they will die either from a heart attack, from the amount of meth they're using, or they're just they're gonna catch something, or they're gonna put themselves in such a ricky richy risky situation that they're gonna end up dead. So, like to me, that is the hardest to treat, I'll be honest, is that meth and sex. Um, it's the because you because most people try to, they try to pull it apart and you just it there, you can't anymore. It's done. Once those two things are together, you've got to just allow the patient to grieve that they will never have that form of sexual experience that has that level of dopamine that meth will give them during sex. Um so we've got to focus on now the trauma because what they're really trying to do is get this intimacy, this connection, this feeling of true love from somebody else, and we let them go off of that high. But we have to teach them how to seek that high without using the meth in sex anymore.

unknown 1:22:02

Thank you.

SPEAKER_01 1:22:02

Yeah.

SPEAKER_07 1:22:05

I can get you next, yeah.

SPEAKER_04 1:22:09

What does sobriety look like in sex education?

Defining Sexual Sobriety And Rebuilding Trust

SPEAKER_01 1:22:16

Well, sex is still involved in in sobriety, right? Because we can't remove that. That's not human, at least not in my head. Um, and so what we look at is how are you using sex? How are you getting sex? What is sex doing for you? Right. So when we have married clients, we still ask them to abstain from sexual activity when they go home. Most of the time, because we want them to build that intimacy first. I need to be able to be intimate with my wife without using sex as the means to do that, right? So, how do we do that? And it's like start talking, have nightly, what did you guys do? Did you guys do nightly meetings to check in? Did you guys do there's a bunch of tools we can give them on how to build that relationship, but it's got to be agreed upon from both partners. Um, some wives don't want to talk to their husbands every night. They're like, I've been dealing with the kids all day. I don't want to sit down with him for the last 30 minutes. I want to get up early, and he needs to get up early and have coffee with me because I want to talk about what our day's gonna look like, right? Um, and some want the end of the day, like I've been with the kids all day or I've been at work all day and done all the kids stuff, and now I just want to decomp with you and I want to make sure your day was okay. And that you've stayed on track and you've been sober for the day too, right?

SPEAKER_03 1:23:40

Yeah.

SPEAKER_01 1:23:41

Any other things that you can think of that was like helpful for you, re-engaging in that relationship?

SPEAKER_06 1:23:50

Uh for me, it was I needed to let my wife lead. Um, that was really important to for her to feel safe no matter what. When I went home, if there was a night that she's like, hey, I just kind of need you to be on the couch tonight, no problem. Sleep great on the couch. That's fine. So I I had to uh not had to. I I got the opportunity to start building back trust with her and the kids in that way. Um yeah, the check-ins. We were doing nightly check-ins there for a while. We were using the um, is it Fanosh? I think was the Fanos. So, you know, feelings, affirmations, needs, that stuff. We were just checking in. Um, that was really helpful. Uh, we still do that not as not every night, but that's still part of it. Um, and I knew, I knew when there, you know, it's like it's not black and white. It's not like I said, it's like I'm fixed. It's like there's times where I feel like I'm being more selfish than than others. And I and I kind of know now, like I'm able to say, like, I was using her in that moment more than I was loving her. And, you know, it's on a spectrum, and you know, it's not like I don't have to feel shame about it, but I part of the tools I was given is I'm able to check in with myself and identify and say, okay, yeah, I was I was needing an escape, and that's what that was about. And let me recalibrate, let me get grounded, let me kind of go through what I need to go through so that it doesn't become a pattern again and snowball and become you know part of it. But yeah, the intimacy part was was great, and then just just letting her lead and making her and the kids feel safe. That was pretty much all I was all I was uh worried about or concerned about in the beginning, just constantly saying that makes sense, you'd feel that way. That totally makes sense you'd feel that way. And what do you need? How can I show up for you? Perfect. And I was not perfect in that. Sounds better than what it was an application.

SPEAKER_01 1:25:36

And then I and then I tell them to live in consultation.

SPEAKER_06 1:25:40

Yeah.

SPEAKER_01 1:25:40

Right? So, like with your therapists, with your groups, with your with your brothers, live in consultation. So if you start to think that, oh God, this has been too long now, we haven't had sex in 45 days, and I've been home. Go talk to your brother about it. Don't go talk to your wife about it first because you're gonna be a little upset and be like, Why haven't we had sex? So that's not gonna help you build your trust. And hey, you know what? I noticed I'm getting really impatient that my wife is still holding this boundary. She still doesn't feel safe. I've been to treatment for 90 days and now I've been home for 45 and I still haven't built the trust up. And is that me? What does that look like? And a lot of times the brothers can be like, dude, do you remember what you did? Do you know how long 90 days is? And then do you know how short 45 is? Right? And then they're like, oh, all right, I'll just keep, right? I'm just gonna keep providing safety. Um, and eventually that trust builds up, and then and then they can start to have healthy sexual behaviors where the wife tends to guide what the boundaries are going into that. Yeah, sometimes that takes much longer than yeah, sorry, um so that's what happens when we start with something like let's talk about sex, right? I mean, I expect it.

SPEAKER_04 1:27:03

If I'm working with the man with a partner of a person who has been using sex or has a sex addiction, or maybe it's unidentified sex addiction behaviors that think we can like show like out of a partner, what are some like we needed to help that person and help that person?

Supporting Betrayed Partners With Boundaries

SPEAKER_01 1:27:24

Teach them boundaries, okay, right? So validation for emotion of things that are coming up. I think I see a lot of the times with betrayed partners that um they're very dysregulated. And so the first thing that people tend to think is borderline personality disorder, and they start treating them as borderline personality, but really there's something they've triggered onto, there's something they've felt, there's a disconnect. And so most of the time, what it is is validating that experience. I hear you, it it feels like there may be a disconnect between your. Husband, and that's upsetting, or um, what what might you think the disconnect is, right? See if you you can pull some stuff out because a lot of times they're detectives and they're searching for what it is that's not right, they're and they go into detective mode like this. They hear something that's off, and all of a sudden now I'm haunting for what's wrong because it's it's never felt like this before. Um, and so just validating that experience that must feel very scary for you. Let's talk about what comes up when you hear that thing, or what is it you were searching for in this moment? What boundaries can you set with your husband that can provide you some safety? Um, you'll notice in an active sex addict very hard is it they're it's very hard for them to keep to those boundaries because those boundaries really do provide them safety, and sex addiction just doesn't do that for the relationship. Um, and so if you notice that they are setting the boundary and they keep getting violated, then it's okay. Now, how do we actually set a boundary and follow through with it once we set the boundary?

SPEAKER_06 1:29:05

Yeah. And you know, like I was gaslighting for years, and so for her to feel like, hey, I was actually right about this stuff, you know, I wasn't crazy the whole time. There was something wrong, and for her to start feeling like she could trust her intuition or instinct and trust herself, like, hey, I, you know, I was I was a master at that. Thank you all for showing up. Thank you for showing me the questions. Yes, Dr. MD, thank you so much. Um, one quick thing before you go, I've been trying to talk myself out of doing this because I don't want to feel um disingenuous or performative, but I feel very compelled to say thank you. Um, my daughter is here with me, she's 12 years old. Um, I get to fly back to Nashville tomorrow to my wife, and I've got three other kids besides her. And um, that's only possible because people like you have chosen to wade out into the mess and to love people like me. So thank you. Thank you for what you do.

SPEAKER_04 1:30:00

Thank you.

SPEAKER_06 1:30:03

Man, I feel like that's an episode I need to go back and listen to over and over again. It's just so rich, so much good stuff in there. Thanks again uh to Dr. MD for being willing to do that and willing to share it. If anything came up for you during that episode, you've got any more questions about it. Um, we'd love to hear from you. You can go to our website, www.viantliving.com, and on there you can find our phone numbers, you can find our emails. Um, you can always email us directly. I'm just deepowell at violentliving.com. I would love to have more of a conversation with you. Um, but that's it for today. I hope you enjoyed it. I hope you found it helpful for you, and look forward to seeing you back here next time on the Viant Living podcast.